CA2400955A1 - Expandable prosthetic cotyle - Google Patents
Expandable prosthetic cotyle Download PDFInfo
- Publication number
- CA2400955A1 CA2400955A1 CA002400955A CA2400955A CA2400955A1 CA 2400955 A1 CA2400955 A1 CA 2400955A1 CA 002400955 A CA002400955 A CA 002400955A CA 2400955 A CA2400955 A CA 2400955A CA 2400955 A1 CA2400955 A1 CA 2400955A1
- Authority
- CA
- Canada
- Prior art keywords
- acetabulum
- cup
- core
- implant according
- cavity
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
-
- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/34—Acetabular cups
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30322—The prosthesis having different structural features at different locations within the same prosthesis differing in surface structures
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30324—The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
- A61F2002/30349—Conically- or frustoconically-shaped protrusion and recess the male and female complementary cones being of different conicities, i.e. for reducing the contact area
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30487—Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30518—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts
- A61F2002/3052—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements with possibility of relative movement between the prosthetic parts unrestrained in only one direction, e.g. moving unidirectionally
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/02—Prostheses implantable into the body
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- A61F2/02—Prostheses implantable into the body
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- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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-
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/30—Joints
- A61F2/32—Joints for the hip
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
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- A61F2002/348—Additional features
- A61F2002/3493—Spherical shell significantly greater than a hemisphere, e.g. extending over more than 200 degrees
-
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3611—Heads or epiphyseal parts of femur
-
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
- A61F2002/4641—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis for disconnecting
-
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- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
-
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
-
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0085—Identification means; Administration of patients
- A61F2250/0089—Identification means; Administration of patients coded with symbols, e.g. dots, numbers, letters, words
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- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
Abstract
Précis Un cotyle expansible et rétractable est conçu pour éliminer les difficultés du positionnement dans l'acétébulum du patient. Ce dispositif comprend un cotyl e hémisphérique partiellement fendu à six endroits, pour faciliter l'expansion par un noyau à emmanchement conique. Le cotyle expansible est conçu pour entrer librement, ou avec une légère pression, dans la cavité osseuse qui a été fraisée au préalable. Le noyau conique est conçu pour être fixé à un impacteur-orienteu r gradué, en degrés, pour maximiser le positionnement souhaité. La force requise pour le positionnement est appliquée graduellement. L'inclinaison et l'antéversion pourront être vérifiées, en tout temps, lors de l'implantation. Le mécanisme retentif de l'impacteur-orienteur permettra de retirer le noyau conique, à volonté, pour repositionner le cotyle, si nécessaire. Le positionnement final sera sécuris é, avec des vis, pour empêcher le noyau de se déplacer. Le remplacement éventuel du coty le sera grandement facilité en retirant les vis et le noyau conique de sa position d e contrainte; le cotyle osseux pourrait alors recevoir un autre implant, suite au fraisage minimum requis.Accurate An expandable and retractable acetabulum is designed to eliminate the difficulties of positioning in the patient's acetabulum. This device includes a hemispherical acetabulum partially split in six places, to facilitate expansion by a core with conical fitting. The expandable cup is designed to enter freely, or with light pressure, into the bone cavity which has been previously milled. The conical core is designed to be fixed to a graduated impactor-orienter, in degrees, to maximize the desired positioning. The force required for positioning is applied gradually. The inclination and anteversion can be checked at any time during installation. The resounding mechanism of the impactor-orientator will allow the conical core to be removed at will to reposition the cup, if necessary. The final positioning will be secured, with screws, to prevent the core from moving. The possible replacement of the coty will be greatly facilitated by removing the screws and the conical core from its stress position; the osseous cup could then receive another implant, following the minimum milling required.
Description
COTYLE PROTHÉTIQUE EXPANSIBLE
La présente invention concerne, d'une manière générale, la mise en place et le maintien d'un cotyle prothétique dans une cavité osseuse. L'invention trouve une application particulièrement avantageuse à la pose de cotyle dans le cadre de prothèse de hanche sans ciment.
On connaît des implants acétabulaires comprenant un cotyle hémisphérique du type à
blocage par compression "press fit". Ce type de cotyle est implanté dans une cavité
osseuse préalablement fraisée par simple impaction ou compression. Avec une telle insertion sous pression du cotyle dans la cavité osseuse, il n'est malheureusement pas possible de procéder à l'entrée graduelle du cotyle dans la cavité, ce qui permettrait de corriger les erreurs de positionnement. De ce fait, plusieurs cotyles à
blocage par compression sont inadéquatement implantés sans qu'il ne soit possible de rectifier la situation tout en préservant l'intégrité des tissus osseux bordant le cotyle prothétique.
Les difficultés du positionnement du cotyle dans facétébulum du patient sont causées principalement par l'installation du cotyle dans l'os avec un niveau de contraintes élevé pour obtenir une meilleure stabilité de l'implant.
De plus, la configuration de la partie hémisphérique du cotyle peut endommager la surface osseuse lors de l'implantation forcée à l'aide d'un impacteur-orienteur. Par surcroît, des vis doivent souvent être installées dans l'os pour assurer la stabilité
primaire de (implant.
Dans cette perspective, l'un des objectifs de la présente invention est de réaliser un cotyle pouvant être inséré et retiré à volonté d'une cavité osseuse destinée à
le recevoir. EXPANDABLE PROSTHETIC COTYLE
The present invention relates, in general, to the establishment and maintenance of a prosthetic acetabulum in a bone cavity. The invention finds a particularly advantageous application to the fitting of a cup in the context of prosthesis cementless hip.
Acetabular implants are known comprising a hemispherical acetabulum of the type at press fit compression. This type of acetabulum is implanted in a cavity bone previously milled by simple impaction or compression. With a such pressurized insertion of the acetabulum into the bone cavity, it is not Unfortunately not possible to proceed with the gradual entry of the acetabulum into the cavity, which would correct positioning errors. As a result, several acetabular cups blocking by compression are inadequately implemented without it being possible to rectify the situation while preserving the integrity of the bone tissue bordering the acetabulum prosthetic.
The difficulties of positioning the acetabulum in the patient's facetebulum are caused mainly by installing the acetabulum in the bone with a level of constraints high to obtain better implant stability.
In addition, the configuration of the hemispherical part of the acetabulum can damage the bone surface during forced implantation using an impactor-Pathfinder. Through in addition, screws must often be installed in the bone to ensure stability primary of (implant.
In this perspective, one of the objectives of the present invention is to make a cup that can be inserted and removed at will from a bone cavity intended for the to receive.
-2-Un autre objectif de la présente invention est de réaliser un cotyle qui présente une flexibilité radiale pouvant en permettre (insertion libre dans une cavité
osseuse.
Un autre objectif de la présente invention est de permettre le repositionnement d'un cotyle inséré hors position.
Un autre objectif de la présente invention est de réaliser un cotyle pouvant être librement inséré dans une cavité osseuse, sans endommager les tissus bordant cette dernière.
Ces objectifs, de même que les autres objectifs qui apparaîtront mieux par la suite, sont remplis par un implant acétabulaire comprenant un cotyle aménageant une cavité
interne recevant un noyau à emmanchement conique, ledit cotyle étant expansible et rétractable radialement respectivement de par (insertion et le retrait dudit noyau.
Selon une réalisation préférentielle de la présente invention, le cotyle est découpé en secteurs par des fentes orientées suivant des plans méridionaux.
Suivant une caractéristique de (invention, le nouveau concept de positionnement consiste à insérer un cotyle flexible de même diamètre ou avec une légère contrainte par rapport au fraisage du cotyle osseux. Le noyau conique est enfoncé
graduellement dans le cotyle, jusqu'à (obtention d'un positionnement assez rigide pour permettre la vérification de l'inclinaison et de l'antéversion. On peut, à ce stade, repositionner le cotyle à sa position nominale, avec une variation de moins de cinq degrés.
L'enfoncement maximum du noyau conique permet l'expansion radiale de la paroi flexible du cotyle. L'installation d'éléments de fixation permet de sécuriser le positionnement du noyau conique dans le cotyle.
Le remplacement d'un cotyle expansible et rétractable est grandement facilité
en retirant le noyau conique, ce qui a pour effet de libérer les contraintes de la cavité
osseuse. -2-Another objective of the present invention is to produce a cup which presents a radial flexibility that can allow it (free insertion in a cavity bone.
Another object of the present invention is to allow the repositioning of a cup inserted out of position.
Another objective of the present invention is to produce a cup which can to be freely inserted into a bone cavity, without damaging the surrounding tissue this last.
These objectives, as well as the other objectives which will appear better by the after, are filled with an acetabular implant comprising a cup providing a cavity internal receiving a conical fitting core, said cup being expandable and radially retractable respectively by (insertion and removal of said core.
According to a preferred embodiment of the present invention, the acetabulum is cut into sectors by slots oriented along southern planes.
According to a characteristic of (invention, the new concept of positioning consists of inserting a flexible cup of the same diameter or with a slight constraint compared to milling the bone cup. The conical core is pressed gradually in the acetabulum, until (a fairly rigid positioning is obtained for allow the tilt and anteversion check. We can, at this stage, reposition the cup at its nominal position, with a variation of less than five degrees.
Maximum penetration of the conical core allows the radial expansion of the wall flexible cup. The installation of fixing elements makes it possible to secure the positioning of the conical nucleus in the acetabulum.
The replacement of an expandable and retractable cup is greatly facilitated in removing the conical core, which has the effect of releasing the stresses of the cavity bone.
-3-L'invention est expliquée ci-après plus en détails à (aide des dessins annexés dans lesquels:
La Fig. 1 est une vue en perspective, partiellement en sections, d'un implant comprenant un cotyle expansible et rétractable, et un noyau selon une réalisation préférentielle de la présente invention.
La Fig. 2 est une vue en perspective, partiellement en coupe, représentant l'assemblage du cotyle expansible et rétractable.
La Fig. 3 représente le cotyle assemblé selon sa position nominale.
La Fig. 4 est une vue d'élévation en coupe du cotyle.
La Fig. 5 est une vue en coupe partielle du noyau conique.
La Fig. 6 est une vue en coupe agrandie représentant l'expansion radiale du cotyle par le noyau.
Les Fig. 1 et 2 illustrent un implant acétabulaire 10 comprenant un cotyle expansible et rétractable 12 ménageant une cavité interne 14, dans laquelle vient s'engager un noyau 16 destiné à recevoir, dans son logement 18, une tête fémorale non-représentée.
Le cotyle 12 présente un profil extérieur généralement hémisphérique destiné à
venir se fixer dans le cotyle osseux préalablement préparé avec des fraises hémisphériques dont le diamètre est connu. Selon une caractéristique de la présente invention, le cotyle prothétique 12 est dimensionné pour rentrer librement, ou avec une légère pression, dans le cotyle osseux. L'encrage du cotyle 12 dans la cavité osseuse est subséquemment assuré par l'expansion radiale du cotyle 12 résultant de (insertion du noyau 16 dans la cavité interne 14 du cotyle 12. -3-The invention is explained below in more detail at (using the accompanying drawings in which:
Fig. 1 is a perspective view, partially in sections, of an implant comprising an expandable and retractable acetabulum, and a core according to a production of the present invention.
Fig. 2 is a perspective view, partially in section, representing the assembly of the expandable and retractable acetabulum.
Fig. 3 shows the cup assembled according to its nominal position.
Fig. 4 is an elevation view in section of the acetabulum.
Fig. 5 is a partial sectional view of the conical core.
Fig. 6 is an enlarged sectional view showing the radial expansion of the acetabulum by the core.
Figs. 1 and 2 illustrate an acetabular implant 10 comprising a cup expansible and retractable 12 providing an internal cavity 14, into which comes engage a core 16 intended to receive, in its housing 18, a non-femoral head represented.
The acetabulum 12 has a generally hemispherical external profile intended for come fix in the bone cup prepared beforehand with strawberries hemispherical whose diameter is known. According to a feature of this invention the prosthetic cup 12 is sized to fit freely, or with a light pressure, in the acetabulum. The anchoring of the acetabulum 12 in the bone cavity East subsequently ensured by the radial expansion of the acetabulum 12 resulting from (insertion of core 16 in the internal cavity 14 of the acetabulum 12.
-4-Le cotyle expansible 12 est réalisé en matériaux biocompatibles, tels le polyéthylène à
haute densité ou encore en titane, ce qui permettrait de réduire la section flexible. Le cotyle 12 comporte un rebord périphérique 20 délimitant (entrée de la cavité
interne 14. Ce rebord 20 possède une surface interne tronconique 22 (Fig. 4) ayant, par exemple, une conicité de quatre degrés. Tel que représenté par les Fig. 1 et 2, le rebord 20 présente une épaisseur accrue. La surface interne 22 du rebord 20 se prolonge en une surface interne 24, suivant le profile d'une sphère et se termine par un fond plat 26 ménageant un trou central 28.
Le cotyle 12 est découpé en secteurs par des fentes 30 orientées suivant des plans méridionaux. Selon (exemple illustré, six fentes 30 sont uniformément espacées le long de la circonférence du cotyle 12 et ont une pénétration vers le fond de (ordre de 45° à partir du plan d'ouverture du cotyle 12. Toujours selon cette réalisation préférentielle, les fentes 30 définissent entre elles un angle de 60°.
Les fentes 30 ont pour but de faciliter l'expansion radiale du cotyle 12 par le noyau 16. Des rainures circonférentielles 32 sont ménagées sur la surface externe 34 de la partie flexible du cotyle 12 pour assurer une bonne prise du cotyle dans la cavité osseuse après que le cotyle 12 a été radialement dilaté. Les rainures 32 sont, d'une part, parallèles entre elles et, d'autre part, parallèles au plan d'ouverture équatorial du cotyle 12. Les rainures 32 sont disposées sur la partie hémisphérique à des profondeurs qui varient selon (épaisseur de la paroi du cotyle. Ä titre d'exemple, les rainures 32 peuvent être distribuées sur prés de 45° de profondeur à partir du plan d'ouverture du cotyle 12.
Selon la réalisation illustrée à la Fig. 4, une première rainure 32 pourrait être localisée à 7.5°, une deuxième à 15°, une troisiëme à 22.5°, une quatrième à 30°, une cinquième à 37.5° et une sixième à 45°.
Des trous filetés 35 sont ménagés au centre de chaque segment, dont les axes sont parallèles à la surface conique 22, pour recevoir des vis 36 (Fig. 2) en vue de sécuriser le noyau 16 dans le cotyle 12.
Le noyau 16 peut être composé de polyéthylène à haute densité et, préférablement, d'un alliage chrome-cobalt, pour une friction métal sur métal, avec la tête fémorale de -4-The expandable cup 12 is made of biocompatible materials, such as polyethylene to high density or titanium, which would reduce the section flexible. The cup 12 has a peripheral rim 20 delimiting (entry of the cavity internal 14. This rim 20 has a frustoconical internal surface 22 (FIG. 4) having, through example, a taper of four degrees. As shown in Figs. 1 and 2, the rim 20 has increased thickness. The internal surface 22 of the flange 20 is extends into an internal surface 24, following the profile of a sphere and is ends with a flat bottom 26 leaving a central hole 28.
The cup 12 is cut into sectors by slots 30 oriented along Plans Southern. According to (illustrated example, six slots 30 are uniformly spaced the along the circumference of the acetabulum 12 and have a penetration towards the bottom of (order of 45 ° from the opening plane of the cup 12. Always according to this production preferential, the slots 30 define between them an angle of 60 °.
The slots 30 have intended to facilitate the radial expansion of the acetabulum 12 by the core 16. Des grooves circumferential 32 are formed on the outer surface 34 of the part flexible from cup 12 to ensure good grip of the cup in the bone cavity after that the cup 12 has been radially dilated. The grooves 32 are, on the one hand, parallels between they and, on the other hand, parallel to the equatorial opening plane of the acetabulum 12. The grooves 32 are arranged on the hemispherical part at depths which vary according to (thickness of the cup wall. For example, the grooves 32 can be distributed on nearly 45 ° deep from the opening plane cup 12.
According to the embodiment illustrated in FIG. 4, a first groove 32 could to be located at 7.5 °, a second at 15 °, a third at 22.5 °, a fourth at 30 °, a fifth at 37.5 ° and a sixth at 45 °.
Threaded holes 35 are provided in the center of each segment, the axes of which are parallel to the conical surface 22, to receive screws 36 (Fig. 2) in view to secure the core 16 in the acetabulum 12.
The core 16 can be made of high density polyethylene and, preferably, chrome-cobalt alloy, for metal-to-metal friction with the head femoral
-5-la prothèse. Le noyau 16 comporte une portion tronconique 38 ayant une conicité
légèrement supérieure à celle de la surface interne 22 du cotyle 12. Par exemple, pour la conicité de la portion tronconique 38 qui est de 6°, une conicité de 4 à 5° de la surface interne 22, permet de répartir la pression en priorité sur le rebord përiphérique. Tel qu'illustré à la Fig. 6, l'angle de 6° de la portion tronconique 38 du noyau 16 permet l'expansion radiale du cotyle 12, jusqu'à 1 mm sur une distance de 9.5 mm, en enfonçant le noyau 16 à la profondeur maximale dans le cotyle 12, soit moins de IO mm. La réduction de l'angle de la surface interne (de 4 à
5° ) du cotyle 12, permet au cône (de 6°) d'appuyer prioritairement sur le rebord périphérique interne du cotyle expansible, afin de maximiser la déformation sur le rebord périphérique externe et ainsi obtenir une meilleure rétention primaire du cotyle 12.
Le modèle représenté à la Fig. 5 comporte une rainure extérieure circonférentielle 39 s'étendant au-dessus de la portion tronconique 38. La rainure 39 permet au noyau 16 d'être retenu fermement par un impacteur-orienteur utilisé lors de l'installation. Cette rainure 39 pourra servir éventuellement si on devait enlever le cotyle 12 pour le réorienter.
Tel qu'illustré à la Fig. l, la surface annulaire de dessus de la portion tronconique 38 agit comme un épaulement pour qu'une portion de la tête des vis 36 prenne appui et ainsi prévienne le retrait du noyau 16.
Selon les procédures d'installation, la cavité osseuse est fraisée au préalable. Par après, le cotyle 12, dans sa position non-sollicitée est inséré librement ou sous une légère pression dans la cavité osseuse. Tel qu'illustré à la Fig. 3, (inclinaison et fantéversion du cotyle 12 devraient être respectivement de 40° et de 15°. Après avoir procédé à l'insertion du cotyle 12, le noyau I6 monté sur un impacteur-orienteur est alors graduellement introduit dans le cotyle 12 jusqu'à l'obtention d'un positionnement assez rigide pour permettre la vérification de l'inclinaison et de fantéversion. On peut, à ce stade, repositionner le cotyle 12 à sa position nominale, avec une variation de moins de 5°. Une fois la position validée, le noyau 16 est enfoncé
jusqu'à la profondeur maximale permettant ainsi un engagement ferme de la paroi du cotyle -5-the prosthesis. The core 16 comprises a frustoconical portion 38 having a taper slightly greater than that of the internal surface 22 of the cup 12. By example, for the taper of the frustoconical portion 38 which is 6 °, a taper of 4 to 5 ° from the internal surface 22, makes it possible to distribute the pressure in priority on the rim peripheral. As shown in Fig. 6, the 6 ° angle of the portion tapered 38 of core 16 allows the radial expansion of the acetabulum 12, up to 1 mm on a distance from 9.5 mm, by driving the core 16 to the maximum depth in the acetabulum 12, is less than 10 mm. Reducing the angle of the internal surface (from 4 to 5 °) of the acetabulum 12, allows the cone (6 °) to press first on the edge peripheral internal of the expandable acetabulum, in order to maximize the deformation on the rim external device and thus obtain better primary retention of the cup 12.
The model shown in FIG. 5 has an outer groove circumferential 39 extending above the frustoconical portion 38. The groove 39 allows the core 16 to be firmly retained by an impactor-orienter used during installation. This groove 39 could possibly be used if the cup 12 were to be removed to the redirect.
As shown in Fig. l, the top annular surface of the portion tapered 38 acts as a shoulder so that a portion of the head of the screws 36 takes support and thus prevents the withdrawal of the core 16.
According to the installation procedures, the bone cavity is milled to the prior. Through afterwards, the acetabulum 12, in its unsolicited position is inserted freely or under a slight pressure in the bone cavity. As shown in Fig. 3 (tilt and fantéversion of the acetabulum 12 should be 40 ° and 15 °. After having proceeded to insert the acetabulum 12, the core I6 mounted on an impactor-East Orienter then gradually introduced into the acetabulum 12 until a positioning rigid enough to allow verification of tilt and fantéversion. We can, at this stage, reposition the cup 12 to its nominal position, with a variation less than 5 °. Once the position validated, the core 16 is pressed up to the maximum depth allowing firm engagement of the cup wall
-6-avec les tissus osseux délimitant le cotyle osseux. Finalement, les vis 36 sont vissées dans le cotyle 12 pour sécuriser le positionnement du noyau 16 dans le cotyle 12.
Au besoin, le cotyle 12 peut être repositionné ou remplacé en retirant les vis 36 et le noyau 16. Ceci permet au cotyle 12 de se rétracter radialement vers sa position initiale. Par la suite, le cotyle 12, libre de contraintes, peut être facilement retiré de la cavité osseuse. -6-with the bone tissue delimiting the acetabulum. Finally, the screws 36 are screwed in the cup 12 to secure the positioning of the core 16 in the cup 12.
If necessary, the cup 12 can be repositioned or replaced by removing the screws 36 and the core 16. This allows the acetabulum 12 to retract radially towards its position initial. Subsequently, the cup 12, free of constraints, can be easily removed from the bone cavity.
Claims (18)
celle dudit noyau. 3, An implant according to claim 1, characterized in that said acetabulum has a peripheral rim delimiting the entrance to said internal cavity, said ledge peripheral having an internal surface having a slightly tapered lower than that of said nucleus.
ladite surface interne conique dudit rebord pour qu'une partie de la tête de chaque vis puisse appuyer sur le dessus d'un épaulement s'étendant extérieurement dudit noyau. 8. An implant according to claim 3, characterized in that holes threaded are arranged in the top surface of said peripheral rim to receive of the screws provided with head, at each of said threaded holes having an axis parallel to said surface conical internal of said flange so that part of the head of each screw can support on top of a shoulder extending outwardly from said core.
osseuse, un noyau à emmanchement conique conçu pour être inséré sous pression dans ledit cotyle et ainsi en forcer l'expansion radiale, le noyau pouvant être retiré
dudit cotyle pour en permettre la contraction radiale vers sa position initiale facilitant ainsi le repositionnement ou le remplacement dudit cotyle. 17. An implant intended to be placed in a damaged joint cavity, comprising an expandable and retractable cup designed to be inserted into a cavity bone, a conical fitting core designed to be inserted under pressure in said acetabulum and thus force its radial expansion, the core being able to be removed of said cup to allow it to contract radially towards its position initial facilitating thus the repositioning or the replacement of said acetabulum.
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002400955A CA2400955A1 (en) | 2002-08-22 | 2002-08-22 | Expandable prosthetic cotyle |
PCT/CA2003/001270 WO2004017870A1 (en) | 2002-08-22 | 2003-08-20 | Expandable, supporting acetabular cup |
AU2003257345A AU2003257345A1 (en) | 2002-08-22 | 2003-08-20 | Expandable, supporting acetabular cup |
US11/060,402 US7553332B2 (en) | 2002-08-22 | 2005-02-18 | Expandable, supporting acetabular cup |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002400955A CA2400955A1 (en) | 2002-08-22 | 2002-08-22 | Expandable prosthetic cotyle |
Publications (1)
Publication Number | Publication Date |
---|---|
CA2400955A1 true CA2400955A1 (en) | 2004-02-22 |
Family
ID=31892662
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002400955A Abandoned CA2400955A1 (en) | 2002-08-22 | 2002-08-22 | Expandable prosthetic cotyle |
Country Status (4)
Country | Link |
---|---|
US (1) | US7553332B2 (en) |
AU (1) | AU2003257345A1 (en) |
CA (1) | CA2400955A1 (en) |
WO (1) | WO2004017870A1 (en) |
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US7597715B2 (en) | 2005-04-21 | 2009-10-06 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8123814B2 (en) | 2001-02-23 | 2012-02-28 | Biomet Manufacturing Corp. | Method and appartus for acetabular reconstruction |
US8066778B2 (en) | 2005-04-21 | 2011-11-29 | Biomet Manufacturing Corp. | Porous metal cup with cobalt bearing surface |
US8266780B2 (en) | 2005-04-21 | 2012-09-18 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8292967B2 (en) | 2005-04-21 | 2012-10-23 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8021432B2 (en) | 2005-12-05 | 2011-09-20 | Biomet Manufacturing Corp. | Apparatus for use of porous implants |
US8128631B2 (en) * | 2005-07-28 | 2012-03-06 | Alexandria Research Technologies, Inc. | Apparatus and method for placing an implant in vivo |
DE102007031669A1 (en) * | 2006-08-04 | 2008-09-11 | Ceramtec Ag Innovative Ceramic Engineering | Asymmetrical design of acetabular cups to reduce cup deformations |
DE102007031667A1 (en) * | 2006-08-04 | 2008-02-14 | Ceramtec Ag Innovative Ceramic Engineering | Insertion of vibration-damping elements in prosthetic systems for manipulation and damping of natural frequencies |
US8029574B2 (en) | 2006-11-07 | 2011-10-04 | Biomedflex Llc | Prosthetic knee joint |
US20110166671A1 (en) | 2006-11-07 | 2011-07-07 | Kellar Franz W | Prosthetic joint |
US8070823B2 (en) | 2006-11-07 | 2011-12-06 | Biomedflex Llc | Prosthetic ball-and-socket joint |
US8308812B2 (en) | 2006-11-07 | 2012-11-13 | Biomedflex, Llc | Prosthetic joint assembly and joint member therefor |
US8512413B2 (en) | 2006-11-07 | 2013-08-20 | Biomedflex, Llc | Prosthetic knee joint |
WO2008058205A1 (en) | 2006-11-07 | 2008-05-15 | Biomedflex, Llc | Medical implants |
US9005307B2 (en) | 2006-11-07 | 2015-04-14 | Biomedflex, Llc | Prosthetic ball-and-socket joint |
US7909882B2 (en) * | 2007-01-19 | 2011-03-22 | Albert Stinnette | Socket and prosthesis for joint replacement |
US7780740B2 (en) * | 2007-05-21 | 2010-08-24 | Active Implants Corporation | Methods, systems, and apparatus for implanting prosthetic devices into cartilage |
DE102008047627A1 (en) * | 2008-08-01 | 2010-02-04 | Smith & Nephew Orthopaedics Ag | Positioning aid in the form of a self-fixing trial acetabulum |
US9820853B2 (en) * | 2009-05-06 | 2017-11-21 | Biomet Manufacturing, Llc | Acetabular cup system |
AU2011264852B2 (en) | 2010-06-08 | 2016-09-01 | Smith & Nephew, Inc. | Implant components and methods |
US9220599B2 (en) * | 2010-08-24 | 2015-12-29 | Biomet Manufacturing, Llc | Acetabular cup having deformation resistant features |
CN103732165A (en) | 2011-06-16 | 2014-04-16 | 史密夫和内修有限公司 | Surgical alignment using references |
GB201121529D0 (en) * | 2011-12-15 | 2012-01-25 | Springer Thorwald | A prosthetic acetabular cup |
US8556986B2 (en) * | 2012-01-18 | 2013-10-15 | George J. Haidukewych | Acetabular prosthetic device |
US9005304B2 (en) | 2012-01-18 | 2015-04-14 | George J. Haidukewych | Acetabular prosthetic device |
WO2013120080A1 (en) | 2012-02-10 | 2013-08-15 | Cornerstone Partners, Llc | Acetabular components for artificial hips |
ITUD20120179A1 (en) * | 2012-10-24 | 2014-04-25 | Limacorporate Spa | ACETABULAR PROSTHESIS AND ITS PROCESS OF MANUFACTURING AND ASSEMBLY |
EP2873392B1 (en) * | 2013-11-14 | 2016-03-30 | Arthrex, Inc. | Shoulder implant with stem |
GB201417694D0 (en) * | 2014-10-07 | 2014-11-19 | Univ Warwick | An acetabular cup for a hip replacement joint |
ES2879811T3 (en) | 2014-11-07 | 2021-11-23 | Smed Ta Td Llc | Implants with groove patterns |
US20170086980A1 (en) * | 2015-09-25 | 2017-03-30 | DePuy Synthes Products, Inc. | Acetabular cup taper cover and liner trial |
TWI571252B (en) * | 2015-12-29 | 2017-02-21 | 財團法人金屬工業研究發展中心 | Acetabular cup structure |
WO2018220140A1 (en) | 2017-05-31 | 2018-12-06 | Medichanical Engineering Aps | Measuring equipment for use in connection with hip prosthesis surgery |
CN113768670B (en) * | 2021-09-10 | 2022-10-14 | 浙江大学 | Prosthesis structure for total-joint resection with acetabulum posterior column reserved |
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FR2798841B1 (en) * | 1999-09-28 | 2002-03-01 | Depuy France | ACETABULAR IMPLANT FOR HIP PROSTHESIS |
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DE10103482C2 (en) * | 2001-01-26 | 2002-12-19 | Mathys Medizinaltechnik Ag Bet | expandable socket |
-
2002
- 2002-08-22 CA CA002400955A patent/CA2400955A1/en not_active Abandoned
-
2003
- 2003-08-20 AU AU2003257345A patent/AU2003257345A1/en not_active Abandoned
- 2003-08-20 WO PCT/CA2003/001270 patent/WO2004017870A1/en not_active Application Discontinuation
-
2005
- 2005-02-18 US US11/060,402 patent/US7553332B2/en not_active Expired - Fee Related
Also Published As
Publication number | Publication date |
---|---|
US20050171614A1 (en) | 2005-08-04 |
AU2003257345A1 (en) | 2004-03-11 |
WO2004017870A1 (en) | 2004-03-04 |
US7553332B2 (en) | 2009-06-30 |
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